What Is a Claim Settlement Ratio? And How Is it Important?

When selecting an insurer, you should consider the claim payment ratio. The higher the ratio, which compares the number of payouts or claims settled, the better it is for you as a prospective policyholder.

A claim settlement ratio is calculated by:

The total number of Claims Accepted / Total Number Received is the claim settlement ratio.

According to Claim Statistics, ICICI Lombard Claim Settlement Ratio for the FY 2022-23 is 99.7%.

What does CSR convey?

This statistic relates to all the claims the health insurer has successfully settled. You can compare various insurance firms’ settlement ratios with ICICI Claim Settlement Ratio to know which is the best one to go for.

What is the importance of CSR for insurance?

  • A high claim settlement percentage can make things easier for you in difficult times. In addition, claim settlement is a significant issue in establishing the trustworthiness of an insurance provider.
  • This ratio reveals how many claims the company has successfully resolved compared to all claims it has received in a financial year. An insurance policy is also a pledge to your loved ones that their financial requirements will be taken care of, thanks to a smooth claim settlement process.
  • You will trust the insurer more if the settlement ratio is higher.
  • You may rest easy knowing that the insurance provider has general high-risk management capabilities and has established the essential procedures for identifying and dealing with improper claim submissions.

The Claim Settlement Process:

1. Making a claim

A policyholder can report the matter to the insurance company via email, SMS, physically visiting the insurer’s office, or by other means. As a policyholder, you must gather all the information and act as an objective third party.

For instance, if you have met with an accident and making a claim, you must record the sequence of events and makes notes in case of an accident, either manually in a notepad or digitally via a smartphone. Pictures of the scene are helpful since they provide appropriate visual evidence. One must meticulously record the date, time, contact information, licence plate, and registration number of the other party’s car. You should record the investigating officer’s contact information for future use if it involves the police. In addition, one must document vital information if medical personnel are on-site at the accident scene.

2. Submitting all necessary documents

The policyholder is responsible for submitting the necessary paperwork as soon as possible after filing a claim so that insurance companies can rapidly evaluate and authorise the same. The claim adjuster examines the policyholder’s coverage, establishing the maximum amount that person can collect from their insurance, and helps the insurance provider to decide the sum given as a payout.

3. Processing the claim

During the claim settlement procedure, the policyholder and his family should experience as little stress as possible. In recent years, insurers have been able to resolve claims more quickly because of technological advancements.

How to avoid claim rejection

The specifics of insurance policies vary from insurer to insurer. For example, your insurance policy may have specific exclusions for collision instances or monetary limits. A policyholder must fill out the claims form correctly, disclose all details, and submit all relevant documents. Each insurance company demands payment obligations with information from the various stages of the claim inquiry. Sometimes, if the numbers and the facts line up, the settlement is reached swiftly and smoothly.

If there are disagreements on the claim obligations, the insurers turn to Arbitration Forums, a non-profit entity specialising in resolving insurance-related conflicts. Arbitration Forums establish a panel that hears both parties’ arguments and finally renders a decision.

It is wise to read the terms and conditions of a policy during the free loo-in period. One should inform his/her nominee after purchasing a policy so that if he/she is indisposed, the nominee can make a claim. The chances of rejection are less if one follows the correct procedure.


A policyholder might get valuable information into an insurance provider’s ability to pay claims by looking at the insurer’s claim settlement ratio. When comparing insurance providers, the policyholder needs to look at more than just the claim settlement ratio. Choose a policy that is most suited to your requirements.

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